Correlation between symptoms and radiological findings in patients of chronic rhinosinusitis: a modified radiological typing system.

BACKGROUND: CT scan and nasal endoscopy are increasingly being used in diagnosing and treating patients of chronic rhinosinusitis. Though CT scan accurately depicts the sinus pathology its use as a proxy in assessing the symptom severity of patients is debatable. In this study the symptom severity of chronic rhinosinusitis was correlated with the author's modified CT scan score.
METHODS: The study involved the examination of symptom severity and CT scan scores of a series of 240 adult patients with chronic rhinosinusitis. The CT scans were evaluated and scored as per author's modified CT scan staging. The pathology at ostiomeatal complex was analysed for its association with severity of symptoms.
RESULTS: The mean CT score of group B patients (8.35) was found to be significantly higher than patients of group A (3.22). In maxillary and frontal sinus there was a statistically significant association of group B patients (moderately severe and severe symptoms) with stage IV of CT scan stage. Although the symptom score of patients with pathology at the ostiomeatal complex on CT scan was found to be higher in group B there was no correlation with anatomical variations at the ostiomeatal complex.
CONCLUSIONS: The study group showed a statistically significant increase in the sinus involvement and CT scan scores with increasing symptom severity. The study indicates a strong association between the symptom severity of chronic rhinosinusitis patients with CT scan scores, with the scores calculated using modified CT scoring criteria. These criteria would help the clinician to accurately predict symptom severity by CT scan scores.